Organization
WILLIAM J LIVESAY JR DO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM J LIVESAY JR. MD (OWNER)
(843) 367-0872
Entity
Organization
Contact information
Practice address
9181 MEDCOM ST, N CHARLESTON, SC 29406-9168
(843) 266-9002
Mailing address
125D WAPPOO DRIVE, CHARLESTON, SC 29412
(843) 266-9002
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
3910
AZ
Other
Enumeration date
03/31/2008
Last updated
03/31/2008
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